Individual provider Active NPI

Larry H Prunty, RPH

  • Pharmacist
  • Middlebourne, WV
National Provider Identifier
1144459520
Registry record updated Jul 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
3852 Issued in WV
Practice address
300 Underwood St
Middlebourne, WV 26149-9657
Phone
(304) 758-2816
Fax
(304) 758-4365
NPI assigned
Jul 7, 2009
Last updated
Jul 7, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 3852 WV Primary

Addresses

Primary practice location

300 Underwood St
Middlebourne, WV 26149-9657

Mailing address

300 Underwood St
Middlebourne, WV 26149-9657
Phone (304) 758-2816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
3852WVMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246924800000",
    "number": "1144459520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 UNDERWOOD ST",
            "city": "MIDDLEBOURNE",
            "state": "WV",
            "postal_code": "261499657",
            "telephone_number": "304-758-2816",
            "fax_number": "304-758-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 UNDERWOOD ST",
            "city": "MIDDLEBOURNE",
            "state": "WV",
            "postal_code": "261499657",
            "telephone_number": "304-758-2816",
            "fax_number": "304-758-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUNTY",
        "first_name": "LARRY",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-07",
        "last_updated": "2009-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "3852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebourne, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.